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Introduction: High-resolution ultrasound (HRU) allows one to identify small nerves, but in the clinical setting, intercostobrachial nerve (ICBN) and medial brachial cutaneous nerve (MBCN) are not identified with conventional portable ultrasound (CPU) devices. The aim of this study is to identify both nerves and describe their relation with specific anatomical structures which could be easily identified with the ultrasound devices available in the clinical setting.
Methods: 21 healthy patients were scanned using HRU bilaterally in the axillary area located over the conjoint tendon to find the ICBN and MBCN and describe their anatomic relations. 5 fresh cadavers were used to validate the previous anatomical findings. ICBN and MBCN ultrasound-guided block was performed with 5 mL of methylene blue and iodine contrast, and the distribution was assessed by both CT scan and dissection.
Results: ICBN and MBCN were identified in all cases. The average distance of the ICBN branches to the artery was 35±6 mm in men and 27±5 mm in women. Constant identification of the muscle-tendon junction of the latissimus dorsi muscle with respect to the location of the branches of the ICBN nerve was observed. Dissection and CT scan confirmed these findings.
Conclusion: HRU is a useful tool to identify ICBN and MBCN nerves, and to describe structures which can be easily identified with CPU use in the clinical setting.
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http://dx.doi.org/10.1136/rapm-2019-100689 | DOI Listing |
J Clin Ultrasound
November 2024
Department of Rehabilitation Medicine, Neuromusculoskeletal Institute, Rowan-Virtua School of Osteopathic Medicine, Sewell, New Jersey, USA.
A 40-year-old woman presented with chronic left anterior shoulder, upper arm, and axillary pain following a routine mammogram 3 years prior. Despite multiple interventions, her pain persisted significantly affecting her quality of life. Ultrasound examination revealed fascicular edema in the medial brachial cutaneous nerve (MBCN), intercostobrachial cutaneous nerve (ICBN), and a positive sono-Tinel.
View Article and Find Full Text PDFReg Anesth Pain Med
August 2019
Department of Anesthesia, Hospital Clinic, University of Barcelona, Barcelona, Spain
Introduction: High-resolution ultrasound (HRU) allows one to identify small nerves, but in the clinical setting, intercostobrachial nerve (ICBN) and medial brachial cutaneous nerve (MBCN) are not identified with conventional portable ultrasound (CPU) devices. The aim of this study is to identify both nerves and describe their relation with specific anatomical structures which could be easily identified with the ultrasound devices available in the clinical setting.
Methods: 21 healthy patients were scanned using HRU bilaterally in the axillary area located over the conjoint tendon to find the ICBN and MBCN and describe their anatomic relations.
Reg Anesth Pain Med
November 2018
Unit of Methodology, Data Management, Statistic, CHRU Nancy, France.
Background And Objectives: For superficial surgery of anteromedial and posteromedial surfaces of the upper arm, the medial brachial cutaneous nerve (MBCN) and the intercostobrachial nerve (ICBN) must be selectively blocked, in addition to an axillary brachial plexus block. We compared efficacy of ultrasound-guided (USG) versus conventional block of the MBCN and the ICBN.
Methods: Eighty-four patients, undergoing upper limb surgery, were randomized to receive either USG (n = 42) or conventional (n = 42) block of the MBCN and the ICBN with 1% mepivacaine.
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